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Selected news releases for today's health care executives

Overview
  
Financial success or failure of a Medicare ACO will depend on meeting rules-based budgets set by the Centers for Medicare and Medicaid Services. To be successful, the Medicare ACO will need to demonstrate quality and reduce spending below targets. However, improving quality is not likely to generate the monetary savings that CMS or ACOs seek.

Few organizations have sufficient assets for the board to gamble on the ACO program's financial downside without carefully assessing the risk. How should they evaluate this risk? Data is important, but data does not organize itself into risk analysis. Risk analysis requires actuarial models that can find and benchmark opportunities in particular categories of medical service utilization.

Physicians and hospitals are facing unprecedented pressures from healthcare purchasers to deliver increased value. It will be increasingly difficult for individual providers to continue operating under the status quo and that further provider integration is inevitable.

The proposed ACO regulation released by HHS on March 31, 2011 will make financial success elusive for most of these emerging organizations. For many, a partnership with a health plan will be much more attractive than becoming an ACO serving Medicare fee-for-service beneficiaries.
 
Learning Objectives
 
Participants will be able to:
  1. Understand risk analysis that is based upon actuarial models that identify and benchmark opportunities in specific medical service utilization categories
  2. Explore the relationship between actuarial models and ACO operational decisions
  3. Identify key specific financial risk concerns for potential Medicare ACOs under the proposed rules for the Medicare Shared Savings Program
  4. Consider the factors involved for high-performing, and less efficient systems to attempt to beat ACO benchmark targets
  5. Examine the potential opportunities from provider-health plan ACO partnerships
  6. Evaluate the application of actuarial models for ACOs operating under health plan partnership in the commercial sector
  7. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group
Who Should Attend
  
 
Interested attendees would include:
  • C-Suite Executives
  • Strategy and Planning Executives and Staff 
  • Actuarial Executives and Staff
  • Medical Directors
  • Managed Care and Revenue Cycle Executives and Staff
  • Operations Executives and Staff
  • Provider Network Managers and Staff
  • Provider Contracting Managers and Staff
  • Analytics and Informatics Managers and Staff

Attendees would represent organizations including:

  • Hospitals
  • Provider Networks
  • Medical Groups 
  • Health Plans 
  • Solutions Providers 
  • Associations, Institutes and Research Organizations 
  • Government
  • Media
  • Other Interested Parties
Registration
  
Individual Registration Fee: $195. Audio Conference CD-ROM: $40 for attendees; $285 for non-attendees after the event.

Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!

 

 

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